The gamble of getting off antidepressants

Antidepressants have always been controversial. Do they work? Don’t they work? Okay, they work but for how many? Side effects, benefits, risks, the unknowns. At the end of the day, no one really knows why they work so well for some and not at all for others. At the end of the day we have to admit to ourselves that there is simply a vast amount we do not know and may never know about the brain. The answer to whether antidepressants are okay long term, that answer comes in a million shades of grey.

I have been on antidepressants now for just about 19 years consistently. I’ve been on nefazodone, venlafaxine, paroxetine, and now both sertraline and bupriopion. Some I transitioned from because the side effects were too incompatible with a productive life, the current dual therapy does, for the moment, create the right balance to keep me grounded in life. Yet every day I seem to come across an article or blog professing the evils of antidepressants and the futility their prescription results in for many. Articles, with catchy little meme images like pictured here that sing the virtues of psychotherapy, positive thinking, meditation and exercise as the magic keys to regulated happiness, not a pill. Perhaps it is because inherently depression is a disease of self-doubt and self-hatred that I find myself buying into this – if for no other reason that it gives my brain license to beat myself up for something else I’m failing at – being able to reign in the crippling thoughts and emotions of depression without medication(s).

This is dangerous thinking. It is not by some fluke that I haven’t ended my life or ended up covered in scars where I’ve tried to give visibility to a disease that no one can see. Those controversial medications have saved me from myself. Yes, I put work into that too but I have to keep reminding myself that I went for years before trying medication barely existing inside but maintaining a pleasant outside. That when, for whatever reason, the current medication regimen starts to lose effectiveness – no amount of meditation, talking, praying, or long walks seemed to make a difference in the crippling pain I felt being part of this world. It is easy though to forget all of that when the medication is doing its job.

I have found my thoughts wandering toward stopping the antidepressants just to see what would happen after the inevitable period of adjustment back to relying on my brain in its unmedicated form to keep me going. I feel challenged on one hand to prove all of these “antidepressants are a pharmaceutical get rich scheme” are false coupled with a faint glimmer of hope that perhaps there is merit there and my brain is only hurt and not healed by the addition of these pills.

It is a monumental gamble to even debate this with myself and the stakes are my life. Taking that gamble would mean messing with the current “okay” status I’ve managed to achieve after an extremely rough and terrifying 11 months of most certainly not being remotely close to okay. Taking that gamble would mean that a loss would result in a race to medicate again quickly enough to beat my brain’s ability to shut down all desire to live. If “with medication” in not proper combination led to the past 11 months, being without medication entirely  I shudder to even try to imagine the strength of those thoughts. Yet still, I wonder the what if? What if I could live without the side effects of the medications and also be happy?

I’m an introspective person by nature. Every decision is carefully thought over, every facet of my life analyzed and dissected to try to understand. I worry though for all those who do not act carefully and view all of these words being written all over the internet extolling the virtues and success of a medication free life. Unlike writing about controversies in other medications, being too black and white when analyzing the choices to be made among psychiatric medications is often speaking to an audience already prone to impulsivity, shame and self-doubt. It is speaking to an audience of people using antidepressants or considering antidepressants who despite all of the “end the stigma” of mental illness campaigns are still stigmatized every day as weak and stupidly overly emotional.

Like so many other topics, it is time to start ensuring that the information provided highlights the greyness of human existence. There is no absolutely right or absolutely wrong – there is only what works for YOU in this life. At the end of the day if you feel stronger with antidepressants – stay on them. If you feel ready to see if your world can exist without them, do so carefully and cautiously. If you feel you need to exhaust every other possible alternative to medications before travelling that road, have at it. Do not make decisions based on absolutes written by others because nothing in this world is absolute.